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General NPI Number Information
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NPI Number | 1386614139
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Entity Type | Individual
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Provider Name | HEATHER ANDRUS PACHECO MD
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Gender | Female
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 02/02/2021
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Provider Practice Location Address
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Address Line | 231 NAJOLES RD STE 460
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City | MILLERSVILLE
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State | MD
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Zip | 21108-2659
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Country | US
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Telephone | 443-883-8543
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Fax |
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Provider Business Mailing Address
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Address Line | 231 NAJOLES RD STE 460
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City | MILLERSVILLE
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State | MD
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Zip | 21108-2659
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Country | US
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Telephone | 443-883-8563
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | D61708
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | D0061708
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License Number State | MD
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